Abstract :
[en] Introduction Nationwide studies comparing patients with
hepatitis B and C virus (HBV and HCV) infections are
mandatory for assessing changes in epidemiology.
Aim The aim of this study was to compare epidemiological
data and initial management of newly diagnosed patients
with persistent HBV (HBsAg positive) or HCV (detectable
HCV RNA) infection in Belgium.
Patients and methods Data were extracted from two
Belgian observational databases.
Results A total of 655 patients (387 HBV and 268 HCV)
were included. Compared with HCV patients, HBV patients
were younger, more frequently men, more often of Asian or
African origin (43 vs. 10%, P < 0.0001), and less frequently
contaminated by transfusion or intravenous drug use
(9 and 6% vs. 34 and 44%, P< 0.0001). Viral replication was
assessed in 89% of HBV patients. Compared with HCV
patients, HBV patients more frequently had normal alanine
aminotransferase (ALT) levels (65 vs. 29%, P < 0.0001), less
frequently underwent liver biopsy (29 vs. 67%, P < 0.0001),
and were less often considered for antiviral therapy
(25 vs. 54%, P < 0.0001). When taking only HBV patients
with detectable viral replication into consideration, results
remained unchanged. During the multivariate analysis,
ALT was a major factor for performing liver biopsy or
considering antiviral therapy in both groups.
Conclusion HBV and HCV screening policies should be
targeted toward immigrants and intravenous drug users,
respectively. Guidelines recommending systematic search
for viral replication should be reinforced in HBV patients.
HBV patients less frequently underwent liver biopsy and
were less often considered for antiviral therapy compared
with HCV patients. Despite the lack of sensitivity and
specificity, ALT remains a pivotal decision-making tool for
liver biopsy and antiviral therapy in both infections.
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